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General NPI Number Information
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NPI Number | 1952391245
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Entity Type | Individual
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Provider Name | ALEX TEPPER M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/26/2005
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Last Update Date | 11/01/2011
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Provider Practice Location Address
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Address Line | 65 E 96TH ST SUITE 1A
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City | NEW YORK
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State | NY
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Zip | 10128-0730
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Country | US
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Telephone | 212-828-0900
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Fax | 212-828-5360
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Provider Business Mailing Address
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Address Line | 200 E END AVE 9E
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City | NEW YORK
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State | NY
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Zip | 10128-7831
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Country | US
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Telephone | 212-828-0900
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Fax | 212-876-4461
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 206045
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License Number State | NY
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